Epidemiology of Functioning and Disability, Swiss Paraplegic Research, Nottwil, Lucerne 6207, Switzerland.
Occup Environ Med. 2013 Mar;70(3):156-63. doi: 10.1136/oemed-2012-100924. Epub 2012 Dec 13.
Prevention of disability in the ageing workforce is essential for sustaining economic growth in Europe. In order to provide information on entry points for preventive measures, it is important to better understand sociodemographic, socioeconomic and work-related determinants of disability in older employees. We aimed to test the hypothesis that low socioeconomic position and exposure to a stressful psychosocial work environment at baseline contribute to later disability. We further assumed that the association of socioeconomic position with disability is partly mediated by exposure to adverse working conditions.
We studied longitudinal data from the first two waves of the Survey on Health, Ageing and Retirement in Europe comprising 11 European countries. Sociodemographic, socioeconomic and work-related factors (low control, effort-reward imbalance) and baseline disability of 2665 male and 2209 female employees aged between 50 and 64 years were used to predict disability 2 years later. Following the International Classification of Functioning (ICF), disability was subdivided into the components 'impairment' and 'restriction in activities and participation'. Two multilevel Poisson regressions were fitted to the data.
After adjusting for baseline disability and relevant confounding variables, low socioeconomic position and chronic stress at work exerted significant effects on disability scores 2 years later. We found some support for the hypothesis that the association of socioeconomic position with disability is partly mediated by work stress.
Investing in reduction of work stress and reducing social inequalities in health functioning are relevant entry points of policies that aim at maintaining work ability in early old age.
预防老年劳动力残疾对于维持欧洲的经济增长至关重要。为了提供预防措施的切入点信息,了解老年员工残疾的社会人口学、社会经济学和与工作相关的决定因素非常重要。我们的目的是检验以下假设,即在基线时低社会经济地位和暴露于紧张的心理社会工作环境会导致以后残疾。我们进一步假设,社会经济地位与残疾之间的关联部分是通过暴露于不良工作条件来介导的。
我们研究了来自欧洲健康、老龄化和退休调查的前两个波次的纵向数据,涵盖了 11 个欧洲国家。使用社会人口学、社会经济学和与工作相关的因素(低控制、努力-回报失衡)以及基线残疾,对 2665 名男性和 2209 名 50 至 64 岁的女性员工的残疾进行了 2 年后的预测。根据国际功能、残疾和健康分类(ICF),残疾分为“损伤”和“活动和参与受限”两个组成部分。对数据进行了两次多层次泊松回归分析。
在调整了基线残疾和相关混杂变量后,低社会经济地位和工作中的慢性压力对 2 年后的残疾评分有显著影响。我们发现,社会经济地位与残疾之间的关联部分是通过工作压力来介导的,这一假设得到了一些支持。
投资于减少工作压力和减少健康功能方面的社会不平等,是旨在维持早期老年工作能力的政策的相关切入点。